Determination of the prognostic value of [18F]fluorodeoxyglucose uptake by using positron emission tomography in patients with non-small cell lung cancer

The aim of this study was to determine whether quantitative information obtained from [F-18]fluorodeoxyglucose positron emission tomography (F-18-FDG PET) has a prognostic significance for patients with non-small cell lung cancer (NSCLC). We investigated F-18-FDG PET imaging of 73 patients with NSCLC. The maximum standardized uptake value (SUVmax) was significantly different between the histopathological types of tumour (squamous cell carcinoma (n=37, 12.4+/-5.1), adenocarcinoma (n=30, 8.2+/-5.8), bronchioloalveolar carcinoma (n = 4, 2.6 +/- 1.7), P < 0.01). In the univariate analysis of all patients, staging (P=0.0001), tumour cell type (P=0.013), and a SUVmax greater than 7 (P=0.0011) was correlated with survival. However, a multivariate analysis identified staging and SUVmax greater than 7 were affected survival adversely. The mortality rate of patients with group I disease (stage I to stage IIIA) was 5.8 times lower than that of patients with group II disease (stage IIIB to stage IV). Patients with a high SUVmax (≥7) had a 6.3 times higher mortality than those with a low SUVmax, (< 7). By multivariate analysis of patients with squamous cell carcinoma, only grouping affected survival (P = 0.008, relative risk = 4.3). In the case of adenocarcinoma, the SUVmax (>10) correlated exclusively with poorer survival (P=0.031, relative risk = 11.152). F-18-FDG uptake correlated with survival in NSCLC. Especially in adenocarcinomas, the SUVmax was complementary to other known prognostic factors. ((C) 2002 Lippincott Williams Wilkins).